As can be expected from an organ responsible for getting blood throughout the body, the root of heart disease is when that blood flow is blocked.
Symptoms and Types
Coronary artery disease is the most common type of heart disease in the U.S., according to the CDC. It occurs when cholesterol builds up in arteries — called plaque — narrowing the space blood can flow through, a condition called atherosclerosis. Ultimately, the narrowing can build up enough to cause chest pain and shortness of breath — called angina, or it can block the vessel completely, causing a heart attack. Over one million Americans suffer heart attacks each year, according to the American Heart Association.
Diagnosis and Tests
Five symptoms can indicate when someone is having a heart attack and requires immediate emergency care. These include pain in the jaw, neck or back; pain in the arms or shoulder; chest pain; lightheadedness or weakness; and shortness of breath.
A number of factors play a role in heart disease risk. Some include family history and age (if your relatives have heart disease or you are older, your risk goes up), but others you have more control over.
Much of the advice to avoid heart disease is the same health advice given for other conditions: stop smoking, exercise and eat a diet that is low in cholesterol and salt — cholesterol being the source of blockage and salt contributing to higher blood pressure. Other things to avoid in the diet include saturated fats, which typically come from animal fats and oils, and trans fats, which occur in vegetable oil, but have largely been removed from the marketplace because of consumer demand.
According to the NIH, diabetes is a condition that can increase heart disease risk by as much as 100 percent, as the higher levels of glucose in the blood that are characteristic of diabetes can leave fatty deposits in blood vessels, which, like cholesterol plaques, can cause blockage of the heart
In addition to lifestyle changes, some treatments are available to help avoid heart disease. Many of these medications are designed to lower cholesterol.
There are two types of cholesterol. The first, LDL, is called “bad cholesterol” because it is the type that can build up and block blood vessels. The other, HDL, is called “good cholesterol” because it is responsible for transporting LDL to the liver, ultimately removing it from the blood stream.
Optimally, HDL cholesterol levels should be above 40 (measured in milligrams per deciliter of blood) and LDL cholesterol should be below 100, according to the CDC.
The FDA has approved a number of drugs for improving cholesterol levels. Perhaps the best known are statins. They slow cholesterol production by the liver and speed up how fast it removed LDL cholesterol from the bloodstream.
Another class of drug to lower cholesterol is called bile acid sequestrants. These drugs remove bile acids from the body. Because the body produces these acids from LDL cholesterol, more LDL cholesterol will be broken down to replace them.
Niacin and fibrates are other drug classes for improving cholesterol levels. Both increase HDL cholesterol, and niacin lowers LDL cholesterol.
Surgical options can also treat heart disease. Coronary angioplasty is performed over one million times each year on patients in the United States, according to the NIH. In this procedure, a balloon is threaded into the affected blood vessel and inflated, pushing the plaque blocking the artery to the sides of the vessel. Sometimes, this procedure is accompanied by placement of a stent — a mesh tube designed to hold the blood vessel open.
Despite all that is known about it, heart disease is the leading cause of death in both men and women in the United States, according to the CDC, claiming over 630,000 lives in 2006 — more than a quarter of all deaths.
Maria is our expert for medicine, fitness and general health. Her contributions are particularly convincing through completeness, accuracy and her own personal experience. Maria also writes for other health magazines, which has enabled her to build up her expert status.